Elvia Juarez-Mata, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

41625 Issued in CA

Practice address

82204 US Highway 111
Indio, CA 92201-5630

Phone

(760) 775-5552

Fax

(760) 775-5002

NPI assigned

Jan 29, 2007

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elvia Juarez a Dental Corporation

  dba EJ Dental

  • General Practice Dentistry
  • Indio, CA
  • NPI 1285796532
  Medicare reassignment NPD
• Elvia Juarez a Dental Corporation

  dba EJ Dental Practice of Dr. Elvia Juarez DDS

  • General Practice Dentistry
  • Cathedral City, CA
  • NPI 1003982638
  NPD (past) Authorized official
• Elvia Juarez a Dental Corporation

  dba EJ Dental

  • General Practice Dentistry
  • Banning, CA
  • NPI 1467226795
  NPD (past) Authorized official
• Elvia Juarez a Dental Corporation

  dba EJ Dental

  • General Practice Dentistry
  • San Jacinto, CA
  • NPI 1518553809
  NPD (past) Authorized official
• Elvia Juarez a Dental Corporation

  dba EJ Dental & Orthodontics

  • General Practice Dentistry
  • Lake Elsinore, CA
  • NPI 1871926501
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1689710626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82204 US HIGHWAY 111",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015630",
            "telephone_number": "760-775-5552",
            "fax_number": "760-775-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82204 US HIGHWAY 111",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015630",
            "telephone_number": "760-775-5552",
            "fax_number": "760-775-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ-MATA",
        "first_name": "ELVIA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003982638",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kallista Jones
• Malena Morales Jones
• Arva Lynn Jones/Butler, RN
• Sarah May Joseph
• John Peter Josma Sr.
• Paola Juarez
• Rucha Juarez
• Jerry Frank Juhl, PT
• Julio C. Martinez, M.D. Medical Group, Inc
• Christopher Leo Kahm, CAARR

• Dentist in Indio, CA
• Providers in Indio, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.